How much rates vary
Facilitymedian $2,188 · 10th to 90th $550 to $10,000Professionalmedian $4,571 · 10th to 90th $2,818 to $5,888
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,495.41 | Facility | None | $4,466.84 | $4,466.84 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $5,888.44 Typical High $5,888.44 | Professional | None | $2,630.27 | $5,888.44 | $5,888.44 |
BCBS Idaho Setting Facility Modifier None Typical Low $9,120.11 Median $9,772.37 Typical High $11,748.98 | Facility | None | $9,120.11 | $9,772.37 | $11,748.98 |
BCBS Idaho Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,168.69 | $4,897.79 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $1,380.38 Typical High $12,589.25 | Facility | None | $151.36 | $1,380.38 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $4,168.69 | Professional | None | $3,090.30 | $3,630.78 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $2,187.76 Median $5,495.41 Typical High $8,511.38 | Facility | None | $2,187.76 | $5,495.41 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $5,888.44 | Professional | None | $3,162.28 | $5,011.87 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,715.35 Median $4,570.88 Typical High $4,570.88 | Facility | None | $3,715.35 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,754.40 | Professional | None | $4,570.88 | $4,570.88 | $5,754.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,365.16 Median $5,248.07 Typical High $5,888.44 | Professional | None | $4,365.16 | $5,248.07 | $5,888.44 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Facility | None | $2,187.76 | $2,187.76 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,187.76 | $3,162.28 |
United Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $870.96 | Facility | None | $436.52 | $676.08 | $870.96 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,801.89 | $5,495.41 |
21 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,548.82 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $630.96 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,344.23 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $467.74 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $316.23 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,187.76 | $4,168.69 | $4,168.69 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $4,265.80 Typical High $4,570.88 | Professional | 54 · Surgery only | $3,630.78 | $4,265.80 | $4,570.88 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | 55 · Aftercare only | $407.38 | $467.74 | $512.86 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $2,951.21 Typical High $3,162.28 | Professional | 62 · Two surgeons | $2,570.40 | $2,951.21 | $3,162.28 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $4,897.79 Median $5,623.41 Typical High $6,165.95 | Professional | 63 · Small infant | $4,897.79 | $5,623.41 | $6,165.95 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,311.31 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,311.31 | $3,548.13 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $758.58 Typical High $812.83 | Professional | 80 · Assistant surgeon | $645.65 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $645.65 Median $758.58 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $645.65 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $645.65 Median $758.58 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $645.65 | $758.58 | $812.83 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $630.96 Typical High $691.83 | Professional | AS · PA/NP assist | $549.54 | $630.96 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,548.82 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $630.96 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $4,466.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,344.23 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $891.25 Typical High $891.25 | Professional | 55 · Aftercare only | $467.74 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $316.23 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $4,168.69 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,187.76 | $4,168.69 | $4,168.69 |
Where Idaho sits
The same service costs 12.3 times more in Maine than in Washington. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $35,907WA $2,929
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.